Individual provider Active NPI

Katherine Taylor, D.D.S.

  • General Practice Dentistry
  • Clifton, NJ
National Provider Identifier
1740369289
Registry record updated Jul 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02139200 Issued in NJ
Practice address
716 Broad St
Clifton, NJ 07013-1645
Phone
(973) 778-5006
Fax
(973) 458-0247
NPI assigned
Nov 3, 2006
Last updated
Jul 30, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22DI02139200 NJ Primary
General Practice Dentistry 1223G0001X 047407-1 NY

Addresses

Primary practice location

716 Broad St
Clifton, NJ 07013-1645

Mailing address

110 Long Hill Dr
Clifton, NJ 07013-2323
Phone (917) 601-4616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190827003125 NJ Order and Referring Only - DentistPractitioner - Dentist 0941538094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
047407-1NYMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185753600000",
    "number": "1740369289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LONG HILL DR",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132323",
            "telephone_number": "917-601-4616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 BROAD ST",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070131645",
            "telephone_number": "973-778-5006",
            "fax_number": "973-458-0247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02139200",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "047407-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.